DBSA Positive Six (+6) Challenges Kick Off May 1

Thriving is the focus for DBSA’s +6 campaign in 2014—making small changes each month that enhance our well-being. Whether it’s incorporating a new habit, focusing on better sleep, trying something new, or simply taking time to breathe, little things can make a big difference!

Please join us each month, May through October, 2014, as we feature a new +6 challenge aimed at helping you to thrive. Each month’s challenge will correlate with the five measurements identified in the World Health Organization’s five point WHO-5 Well-Being Index, to help you work towards feeling more active and vigorous, cheerful and in good spirits, calm and relaxed, fresh and rested, and engaged by things of interest in your daily life. We’ve added meaningful relationships as our sixth focus because we know how important good support is!

We have had a very lively discussion among peers on our Facebook page about some big questions— “what does it mean to ‘live a thriving life’ when you have a mood disorder?” “How can we do better in a system that sometimes seems designed to see us fail?”.

DBSA Scientific Advisory Board members, Dr. Gregory Simon and Dr. Joseph Calabrese, discussed the limitations of current treatment options for mood disorders and the need within the clinical and patient communities to shift expectations and raise treatment goals to complete remission of symptoms and sustained wellness in our Target Zero to Thrive podcast.

Many people live full lives with problematic symptoms, however we believe the closer we can get to complete remission, the easier it will be for more of our peers to lead full, extraordinary lives. Please join your voice to the thousands who have already pledged support for Target Zero to Thrive, and help us make wellness the norm rather than the exception.

The Parent Connection is a new column appearing each month in the DBSA eUpdate. Here, parents and guardians can expect to find up-to-date information and resources about parenting children and adolescents with depression and bipolar disorder. We also feature news about Balanced Mind Parent Network online support communities, the Family Helpline and other family-focused programming.

Shelle Barnes still keeps the email she received from a Family Helpline volunteer in 2009 as a reminder of the wisdom she was handed when it was first suggested that her daughter Rachel might have bipolar disorder. So it was easy for Shelle to want to turn around and provide that same guidance to other Balanced Mind Parent Network families.

“When I first started on this journey, I was at a loss,” said Shelle, a mother from California whose daughter is now 14. “I want to help other families so it won’t take them years to find the answers they need.”

In early 2012, Shelle signed up to volunteer for The Balanced Mind’s Family Helpline, a lifeline for families who need information and resources specific to their situations and don’t know where else to turn. From behind her computer screen, Shelle researches and responds to online and telephone requests from parents and caregivers who are reaching out and trying to figure out their next steps. Many have children who are newly diagnosed with depression or bipolar disorder, or for whom a mood disorder is suspected. Many are searching for local clinicians or hospitals to treat their children, guidance on how to advocate for their children in educational settings, or even just a supportive shoulder to lean on.

Shelle, one of a team of fifteen volunteers who staff the Helpline, is assigned a request every few weeks by Helpline leader Karen Cruise. Karen matches volunteers with requests based on experience and geographic proximity. Newer volunteers are mentored by more experienced volunteers. All volunteers offer assistance from the Helpline’s online library of information and resources, their own experiences, and shared information from their fellow volunteers. Calls and emails receive a response within 48 hours.

“I do it as a way to pay it forward,” Shelle said. “If I’m able to make a difference, that’s my goal."

Ask the Doc

Q: I have a diagnosis of bipolar, and am taking lithium for my mania. I'm not on an antidepressant, as it will push me into mania, but I'm in so much emotional pain. I only consider taking my life when I'm depressed not manic, what can I do? I need meds for depression, that is what is crucial to keeping me alive.

A: Unfortunately, your situation is a common one. Most people who live with bipolar disorder spend more time feeling depressed than they do feeling speeded up or manic. And traditional mood stabilizer medications—like lithium—are generally more effective for controlling or preventing mania than for controlling or preventing depression.

For people with bipolar disorder, use of antidepressants is controversial. The largest study of antidepressant medication for depression in bipolar disorder found it was—on average—not better than a placebo. For some people, though, antidepressant medications may help reduce symptoms of depression without increasing risk for mania or mood swings. But for some people, antidepressants clearly do bring on mania or more unstable moods ("rapid cycling"). It sounds like you are one of those people who should probably avoid traditional antidepressants.

There are other types of medications you could take along with lithium that might help more with depression. Lamotrigine is a mood stabilizer medication that may help more with depression than lithium or other mood stabilizers. Two of the newer "atypical" medications (Lurasidone and Quetiapine) have been officially approved to treat depression in people with bipolar disorder. Research suggests that some of the other “atypical” medications may also help with depression in bipolar disorder, but they are not specifically approved for that purpose. As you probably know, medications for depression often take two weeks or longer to help. And different medications work for different people, so trial-and-error is sometimes necessary.

Medication may not be the most effective treatment for depression in bipolar disorder. The same large study that found antidepressant medication was not effective for depression in bipolar also found that specific kinds of psychotherapy were clearly effective. Those psychotherapy treatments (Cognitive-Behavioral Therapy, Interpersonal and Social Rhythm Therapy, and Family Focused Therapy) reduced depression in the long term without any risk of more mania or mood swings.

Greg Simon, MD, MPH, is a psychiatrist and researcher at Group Health Cooperative at the Center for Health Studies in Seattle. His research focuses on improving the quality and availability of mental health services for people living with mood disorders, and he has a specific interest in activating consumers to expect and demand more effective mental health care.

Got a nagging question you want to ask a doc? Submit your questions online for a chance to get the answer. Check the next DBSA eUpdate to see if your question was chosen.

In the meantime, take a look through our Ask the Doc feature page, a comprehensive archive of past Ask the Doc features which may already be home to the answers you seek.

Allen DoederleinDBSA President

Note from Allen

I'm thrilled that DBSA is offering a Target Zero to Thrive podcast this month, with two leading clinician-researchers—and longtime friends of DBSA—Greg Simon and Joe Calabrese sharing their perspectives about why the clinical community needs to rethink its endpoints for treatment. With the likelihood and severity of relapse being much greater among those who do not get all of their debilitating symptoms addressed, it behooves clinicians to raise their expectations for treatment. I hope you will not only listen and hear for yourself what they have to say, but that you will also forward the podcast to your networks and, ideally, your doctors!

In the podcast, Joe and Greg also discuss the need to go beyond symptom measurement to incorporating wellness measurements, like the World Health Organization's Well-Being Index, into clinical practices. DBSA's Positive Six campaign encourages our peers to take a monthly challenge from May through October to focus on small changes that enhance well-being.

Survey Results: “Getting Help for Suicidal Thoughts”

The results of the DBSA Consumer and Family Survey Center Getting Help for Suicidal Thoughts survey is now available. How common are suicidal thoughts and actions? What types of help have your peers tried? Which are the most useful? Read answers to those questions and more.

Each quarter, DBSA conducts short, online surveys to help us understand the key issues you face. Stay tuned for more survey opportunities in future e-Updates.

DBSA continues our focus on suicide prevention throughout the month of May on our advocacy blog, CareForYourMind.org.
Subscribe to the Care for Your Mind RSS feed, or visit us each Tuesday for new posts.

Life Unlimited: Molly Jenkins

If I had to pinpoint a time when I first felt the symptoms of depression—the feelings of sadness, aloneness, and worthlessness—I would say it was around the age of eleven or twelve. Sometimes the journey wasn’t all that bad, as when the symptoms were managed through medication and therapy. Sometimes the journey was very rough, however, and I spiraled downward into months-long episodes of major depression. The absolute low point of my journey happened during my junior year of college.

As I entered an episode of major depression, I started to isolate myself from friends and family. I chose to sleep rather than deal with my increasingly intense feelings of self-hatred and worthlessness. I avoided any social interaction because of the fear of judgment. I thought to myself, “If I don’t like me, how can I expect other people to like me?” So I spun deeper and deeper into a world I created for myself—a world which consisted only of me and my dark thoughts.

DBSA Peer Specialist Training

DBSA offers Mental Health First Aid training for Military Members, Veterans, and their Families
Family members and other individuals working with military personnel and their families are often not aware of how to assist Veterans with mental health conditions and addictions, and now there’s a course designed specifically for those who want to be truly helpful. Mental Health First Aid (MHFA) is a live training program—like standard First Aid or CPR—designed to give people the skills to help someone developing a mental health condition or experiencing a mental health crisis. The National Council for Behavioral Health recently developed a MHFA course specific to military-Veteran audiences, and DBSA is proud to announce that we are now certified by the National Council to offer Military-Veteran MHFA for Veterans and those who seek to support them. Contact us for more information on how you can partner with DBSA to offer this course in your area. (Article source materials courtesy of The National Council)
May DBSA Veteran Peer Specialist Training Course
Application Deadline Extended to April 25th!
DBSA Peer Specialist training is nationally-recognized as the gold standard for preparing individuals to become certified as peer specialists, and we are proud to be the national contractor to the United States Department of Veterans Affairs (VA) for training and certification of peer support staff employed by the VA. If you are a Veteran interested in offering recovery support to your peers who also served, apply today for this upcoming DBSA Veteran Peer Specialist Training course and help spread the word about it to other Veterans in your local community!

Care for Your Mind: April Highlights

What’s it like to feel like you are “other” when seeking mental health care? Do you think your providers are culturally sensitive? This topic generated robust conversation in last month’s Care For Your Mind.

OUR MISSION: DBSA provides hope, help, support, and education to improve the lives of people who have mood disorders.

The Power of Peers

DBSA envisions wellness for people who live with depression and bipolar disorder. Because DBSA was created for and is led by individuals living with mood disorders, our vision, mission, and programming are always informed by the personal, lived experience of peers.